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Biomedical subjects

N O Gibbon

Publications and source records attributed to N O Gibbon.

At least 19 recordsLinked to original sources
PubMed1987

Division of the external urethral sphincter in the treatment of the paraplegic bladder: a preliminary report on a new procedure.

Division or resection of the external sphincter is a new operation designed to relieve retention of urine (or a high residue) in patients with an open bladder-neck and a narrow, rigid external sphincter area and in whom subarachnoid alcohol block, pudendal neurectomy or a bladder-neck resection have failed to help. The operation converts a chronic retention to an easily expressible bladder. Ten patients are reported. The operation technique is described. During the post-operative period care is necessary in preventing or dealing with clot-retention and with severe infection due to absorption of organisms in the urethra. The operation should not be attempted in patients with grossly dilated upper urinary tracts and in those with uncontrollable infection. The eight surviving patients have been spared the catheter life and, possibly, subsequent damage to the upper urinary tract.

Adult↗
PubMed1981

Critical evaluation of direct vision urethrotomy by urine flow measurement.

Fifty-two male patients were studied prospectively to assess the results of direct vision urethrotomy in the treatment of urethral strictures. The prognosis was found to be significantly worse in those patients who had received extensive previous treatment. A catheter is recommended for at least 3 days and for 4 weeks in patients who have had minimal previous treatment or who have impaired detrusor function. The use of a urine flowmeter is essential for determining the success of treatment and stricture recurrence. Measurement of the recurrence-free period is important for assessing progressive improvement following repeat urethrotomy and for determining which patients cannot be cured by direct vision urethrotomy.

Adolescent↗
PubMed1980

The neuropathic urethra.

The hypothesis is advanced that the functional urethral obstruction found in neuropathic states is due, in part at least, to urethral supersensitivity following sympathetic decentralisation. A simple postural test for this condition is described. By its use it has been shown that urethral denervation occurs not only in disorders of the central nervous system but with peripheral damage such as may result from rectal excision and hysterectomy. In some cases with functional urethral obstruction, attributable to suersensitivity of the urethra, no neurological abnormality has been found. These may be examples of localised visceral neuropathy.

Female↗
PubMed1978

Outflow obstruction in neuropathic bladder dysfunction: the neuropathic urethra.

Urethral pressure profiles were recorded in a series of patients with traumatic lesions of the spinal cord producing vesico-urethral dysfunction. Patients were classified into groups depending upon the relationship of the lesion to the sympathetic outflow to the bladder and urethra from the spinal cord. Using alpha-adrenergic blocking agents, the smooth muscle contribution to the maximum urethral pressure was ascertained in each group and differences in both the configuration of the profile, and the smooth muscle component, were found. Increases in the maximum urethral pressure in response to a change in posture were also investigated, and the extent of the increase found to vary according to the level of the spinal lesion in respect of the sympathetic outflow, and with the integrity of the sacral cholinergic reflex arcs. The hypothesis that these changes may be due to urethral "decentralisation supersensitivity" from alterations in circulating catecholamine levels is suggested.

Adolescent↗
PubMed1976

Nomenclature of neurogenic bladder.

Vesicourethral physiology is reviewed briefly in the light of recent developments. The effect on bladder function of central nervous system disorders is considered and attention is drawn to the desirability of diverting interest from the bladder to the urethra in neuropathic cases. It is concluded that there are only two basic types of neuropathic bladder function--in lesions of and above the sacral reflex pathways, respectively. Neurologically these are classified according to the condition of the anal and bulbocavernosus reflexes and the ice water test.

Denervation↗
PubMed1976

Factors influencing readmission to hospital. I. Tetraplegia.

Tetraplegia produces exceptionally severe physical impairment causing disability which demands almost total dependence on others for the activities of daily living but there is no impairment of mental function. The tetraplegic is, therefore, capable of influencing his environment and those features of it which may lead to the need for readmission to hospital. Of the factors studied relating to readmission to hospital, only age and occupational status of the patient at the time of his paralysis are of significance.

Activities of Daily Living↗
PubMed1976

Vaginal ureterolithotomy.

The vaginal approach to the low ureteric calculus may provide an easy, rapid and safe solution to a difficult surgical problem. It is important to select the case with care and, provided basic surgical principles are followed, the complications should be minimal. 3 recent successful cases are described and a further 2 in which the technique failed due to proximal displacement of the stone. The importance of adequately immobilising the calculus prior to ureterotomy is emphasised.

Adult↗
PubMed1976

Division of the external urethral sphincter in the neuropathic bladder: a twenty years' review.

It is now twenty years since the authors first performed division of the external sphincter region in the treatment of the neuropathic bladder. Although a ten year report was published in 1967, it was decided to review all the patients at the end of the twenty year period. The rationale of the operation in the upper motor neurone lesion has been confirmed by modern investigative techniques, while it appears from recent work that the success of the procedure in the lower motor neurone case is due to division of plain muscle which is subjected to excessive sympathetic stimulation. It is the authors' firm conviction that long term catheterization, whether permanent or intermittent is a confession of failure and can be avoided in the vast majority of patients. The operation has proved of permanent benefit especially with the regard to the elimination of residual urine. Further, hydronephrosis, and renal infection and failure, are also benefited in many cases. These factors are of great importance in a condition in which late morbidity and mortality has been usually due to renal causes.

Humans↗
PubMed1975

Urethral pressure measurement after division of the external sphincter.

The completeness and permanence of 'division of the external sphincter' is assessed in a group of 30 spinal injury patients. The urethral pressure profile technique is effective in estimating the completeness of the operation. Both in the short-term and the long-term (four month to 16 years) the results of the operation are excellent with no mortality.

Adolescent↗
PubMed1975

Urological implications of food refining.

Evidence is accumulating that food-refining, which results in over-nutrition which carbohydrates as well as deficiency of fibre, protein, etc., is an important factor in the causation of many modern diseases. This concept has important implications for the urologist and may assist in the prevention of common urological problems such as renal calculus and infection.

Dietary Carbohydrates↗